Clinical profile of diseases causing chronic airflow limitation in a tertiary care centre in India

Pulmonary department of a tertiary health care centre in India.

To study the clinical profile of diseases causing chronic airflow limitation (CAL).

Standard criteria were used for the diagnosis for various diseases causing CAL. Severity of CAL was graded using forced expiratory volume in one second (FEV1)% predicted. Pulmonary hypertension (PH) was confirmed by 2-dimensional echocardiography with colour Doppler.

Two hundred sixty eight consecutive patients of CAL, age range 12-75 years, 172 men and 96 women were included in the study. Sixty three percent had asthma, 17% had chronic obstructive pulmonary disease (COPD), 6% had bronchiectasis, 13% had obliterative bronchiolitis (OB) and 1% had occupational airway disease. 98% of COPD was caused by tobacco smoking, of which 84% were bidi smokers. Ninety-two percent cases of OB were post infectious, 78% being post tuberculosis. 37% of COPD, 33% of bronchiectasis, 53% of OB and 22% of asthma had severe airflow limitation. PH was observed in 15%, 19% and 13% cases of COPD, OB and bronchiectasis, while none with asthma had PH.

Although, asthma was the leading cause of CAL, it caused least functional impairment. CAL due to OB was as common as COPD. Bidi smoke was an important cause of COPD, while respiratory infection was common cause for OB.